本文選題：兒童 + 癲癇　； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的： 對我院神經(jīng)內(nèi)科門診和住院確診為癲癇患兒的頭顱影像學(xué)（MRI、CT）、EEG等輔助檢查和藥物治療等情況進(jìn)行綜合回顧性分析，以初步探討其頭顱影像學(xué)檢查結(jié)果、腦電圖改變情況和藥物治療效果的相關(guān)性。 方法： 通過收集2011年8月至2013年1月在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院神經(jīng)內(nèi)科�？崎T診和住院部，通過臨床發(fā)作、頭顱影像學(xué)和腦電圖檢查確診為癲癇，并規(guī)律服用抗癲癇藥物（AEDs）的106例患兒的臨床資料，，進(jìn)行隨訪。入組時106例患兒均行EEG檢查、頭顱MRI（或頭顱CT）檢查。隨訪時間為用藥后至少6月，至少隨訪3次，隨訪內(nèi)容為AEDs治療后患兒癲癇發(fā)作控制情況、EEG、MRI等輔助檢查的改變、藥物毒副反應(yīng)等情況。治療效果以癲癇發(fā)作控制情況評定。 結(jié)果： 初期入組114例，除外失訪8例，最終入組106例，其中包括自行停藥12例、死亡3例。男61例，女45例，年齡1月-12歲，平均5.02±3.71歲。療效以臨床發(fā)作控制情況為標(biāo)準(zhǔn)，分為有效控制（完全控制+部分控制）和無效控制。分組分析結(jié)果：1.根據(jù)頭顱影像學(xué)檢查結(jié)果分為影像學(xué)正常組（A1組）67例、異常組（A2組）39例，兩組療效之間比較差異具有顯著性（χ2=6.47, P0.05）；2.根據(jù)腦電圖檢查結(jié)果分為腦電圖正常組（B1組）11例、異常組（B2組）95例，兩組療效之間比較無明顯差異（P0.05）；3.根據(jù)頭顱影像學(xué)和腦電圖檢查結(jié)果分為影像學(xué)+腦電圖異常組（C1組）38例、影像學(xué)+腦電圖非完全異常組（C2組）68例，兩組療效之間比較差異具有顯著性（χ2=7.15，P0.05）。4.根據(jù)隨訪后復(fù)查腦電圖改變情況又分為腦電圖恢復(fù)正常組（D1組）45例、腦電圖持續(xù)異常組（D2組）61例，兩組療效之間比較有顯著性差異（χ2=10.33，P0.05）。5.根據(jù)隨訪后患兒服用AEDs有無明顯毒副反應(yīng)的情況，分為無毒副反應(yīng)組（E1組）86例，有毒副反應(yīng)組（E2組）20例，兩組療效之間比較無差異（P0.05）。目前仍有92例保留治療，保留治療率為80.70%。 結(jié)論： （1）頭顱影像學(xué)（MRI、CT等）異常是影響兒童癲癇治療效果的重要因素，頭顱影像學(xué)檢查異常者其療效低于正常者。 （2）EEG持續(xù)異常也是影響兒童癲癇治療效果的重要因素，EEG持續(xù)異常者其療效低于恢復(fù)正常者。 （3）MRI/CT、EEG均異常者，其療效較無明顯異常者更差。 （4）目前AEDs治療兒童癲癇的整體療效較好，不同類型的AEDs在治療兒童癲癇時具有良好的耐受性及較高的保留治療率，且兒童使用抗癲癇藥物后的毒副反應(yīng)相對較輕。
[Abstract]:Objective: to study the results of cranial imaging (MRICT) EEG and drug therapy in children with epilepsy diagnosed in outpatient and inpatient department of neurology in our hospital. The correlation between EEG changes and the effect of drug therapy. Methods: from August 2011 to January 2013, patients with epilepsy were diagnosed by clinical seizures, cranial imaging and electroencephalogram in the Department of Neurology, Department of Neurology, affiliated Children's Hospital of Chongqing Medical University. The clinical data of 106 children with regular antiepileptic drugs (AEDs) were followed up. EEG and cranial MRI (or CT) were performed in 106 children. The follow-up time was at least 6 months after treatment, and at least 3 times. The contents of follow-up were the changes of EEGG MRI and the side effects of drugs in children with epilepsy after AEDs treatment. The therapeutic effect was evaluated by epileptic seizure control. Results: there were 114 cases in the initial group, except 8 cases of lost visit, and 106 cases in the final group, including 12 cases of self-withdrawal and 3 cases of death. There were 61 males and 45 females, aged from 1 month to 12 years (mean 5.02 鹵3.71 years). The curative effect is divided into effective control (complete control partial control) and ineffective control according to clinical seizure control. The result of the grouping analysis was: 1. According to the results of cranial imaging, 67 cases of normal imaging group (A1 group) and 39 cases of abnormal group (A2 group) were divided into two groups. There was significant difference between the two groups (蠂 2 6.47, P0.05). According to the results of EEG examination, 11 cases were divided into normal EEG group (B1 group) and 95 cases abnormal group (B2 group). There was no significant difference between the two groups (P0.05). According to the results of brain imaging and EEG examination, 38 patients were divided into abnormal EEG group (C1 group) and 68 patients with incomplete abnormal EEG (C2 group). There was significant difference between the two groups (蠂 2 7.15P 0.05). According to the changes of EEG after follow-up, 45 patients were divided into normal EEG group (D1 group) and 61 patients with persistent abnormal EEG (D2 group). There was significant difference between the two groups (蠂 2 10.33 P 0.05). According to the results of follow-up, the children were divided into two groups: no side effect group (E 1 group, n = 86) and no side effect group (E 2 group, n = 20). There was no significant difference between the two groups (P0.05). At present, there are 92 cases of retention therapy, the retention rate is 80.70%. Conclusion: (1) abnormal cranial imaging (MRII-CT, etc.) is an important factor affecting the therapeutic effect of epilepsy in children. (2) continuous abnormal EEG is also an important factor affecting the therapeutic effect of epilepsy in children. (3) patients with abnormal EEG are lower than those who return to normal. (3) patients with abnormal MRI / CTE EEG are all abnormal. The efficacy of AEDs is worse than that of those without obvious abnormalities. (4) the overall efficacy of AEDs in the treatment of childhood epilepsy is better. Different types of AEDs have good tolerance and high retention rate in the treatment of childhood epilepsy. The side effects of antiepileptic drugs in children were relatively mild.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R742.1

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